The medical system in Russia
I think I have talked a little about the tendency of Russian orphans to have a long list of diagnoses, most of which are totally exaggerated or bogus. I read today that the reason for the exaggerated medical records is to ensure continued medical care for the orphans. Russia has a socialized medical system and apparently having documented diagnoses (whether they are true or not) will help to ensure they get the medical care they need.
I also just found this on the internet:
The philosophy of health care in Russia is different from the U.S. It's more like Europe by the way doctors are trained to address relatively minor things more seriously than in U.S. They make a list of diagnoses, but are simply describing "risk factors", to let other doctors know: maternal risk factors, infant risk factors.
Doctors and the other experts in child development whom we interviewed for this report frequently criticized this diagnostic tradition. We were therefore particularly dismayed to note that a concise critique of this practice of “over-diagnosing” was presented as long as three years ago to the Council of Europe by an expert team who visited Russia in June 1994.
The experts reported that Russian psychological norms are based on very strict criteria. Apart from these norms, however, factors that in the West are considered as being simple medical risks, will, in Russia, be labeled as illnesses:
*babies born to alcoholic parents or whose mothers suffered depression during pregnancy will be labelled encephalopathic and remain so until they come of age.
*orphans will be classed as being mentally deficient.
*children with a single physical malformation (a harelip or speech defect...) become subnormal in the eyes of Russian doctors.
Human Rights Watch also found that these early diagnostic practices interfere with a child's right to full development and in certain cases, to life, itself. Moreover, abundant information gathered in Russia indicated several crucial incentives behind "over-diagnosing" that suggest violations of basic medical ethics.
According to a former charity worker who distributed assistance to impoverished baby houses and has travelled widely in Russia since 1991, one legacy of the Soviet medical bureaucracy encourages hospital staff to avoid any risk of sanctions for errors detected under their care. For example, she recalled the case of a child she knew well who had a medical chart with a catalogue of conditions including oligophrenia and encephalopathy.
A doctor told me that they have to cover their butt. They could lose their job, so they write many diagnoses. And you know the penal system here. It's a “better safe than sorry” system.
A second factor that encourages exaggerated diagnoses, is the Russian law which until recently, prohibited international adoption of "healthy" children. The doctors in the system wanted the kids adopted, so they'd say that this child has a tumor and then “wink” at you.
Finally, a widely cited incentive for over-diagnosing is the extra financial subsidy and salary increment that the state grants to institutions that care for children with disabilities. The entitlement to these subsidies was confirmed by children's rights activists as well as by staff of state institutions.
I have heard all of these things more than once and I think it is all so very interesting ... and it makes sense.
I also just found this on the internet:
The philosophy of health care in Russia is different from the U.S. It's more like Europe by the way doctors are trained to address relatively minor things more seriously than in U.S. They make a list of diagnoses, but are simply describing "risk factors", to let other doctors know: maternal risk factors, infant risk factors.
Doctors and the other experts in child development whom we interviewed for this report frequently criticized this diagnostic tradition. We were therefore particularly dismayed to note that a concise critique of this practice of “over-diagnosing” was presented as long as three years ago to the Council of Europe by an expert team who visited Russia in June 1994.
The experts reported that Russian psychological norms are based on very strict criteria. Apart from these norms, however, factors that in the West are considered as being simple medical risks, will, in Russia, be labeled as illnesses:
*babies born to alcoholic parents or whose mothers suffered depression during pregnancy will be labelled encephalopathic and remain so until they come of age.
*orphans will be classed as being mentally deficient.
*children with a single physical malformation (a harelip or speech defect...) become subnormal in the eyes of Russian doctors.
Human Rights Watch also found that these early diagnostic practices interfere with a child's right to full development and in certain cases, to life, itself. Moreover, abundant information gathered in Russia indicated several crucial incentives behind "over-diagnosing" that suggest violations of basic medical ethics.
According to a former charity worker who distributed assistance to impoverished baby houses and has travelled widely in Russia since 1991, one legacy of the Soviet medical bureaucracy encourages hospital staff to avoid any risk of sanctions for errors detected under their care. For example, she recalled the case of a child she knew well who had a medical chart with a catalogue of conditions including oligophrenia and encephalopathy.
A doctor told me that they have to cover their butt. They could lose their job, so they write many diagnoses. And you know the penal system here. It's a “better safe than sorry” system.
A second factor that encourages exaggerated diagnoses, is the Russian law which until recently, prohibited international adoption of "healthy" children. The doctors in the system wanted the kids adopted, so they'd say that this child has a tumor and then “wink” at you.
Finally, a widely cited incentive for over-diagnosing is the extra financial subsidy and salary increment that the state grants to institutions that care for children with disabilities. The entitlement to these subsidies was confirmed by children's rights activists as well as by staff of state institutions.
I have heard all of these things more than once and I think it is all so very interesting ... and it makes sense.